The below remarks were delivered at Age Concern's Forum last night by the Minister of Health the Hon. Kim Wilson regarding the Bermuda Health Plan.
"Thank you for allowing me to speak to you today about the Bermuda Health Plan and this public consultation process.
I want to start by clarifying that my overarching aim in this entire process is to make sure everyone in Bermuda can be healthier.
This can best be achieved by:
- providing more prevention,
- greater access to healthcare for all and:
- Providing a decent core plan of benefits to keep us healthy.
It does not matter what your current state of health is or how old you are – young or old. We can all be healthier, and that is my Ministry’s mission.
However, this is a very ambitious goal. There is no single act that can fix everything. No magic wands or super pills to cure all ails. Like all of the best things in life – it will take hard work, collaboration and many different efforts to get Bermuda healthier.
Having listened to the public, we know that among the things we need are:
- More prevention
- Access to healthcare for all, and
- A decent basic plan with benefits to keep us healthy
So, among the things we are doing to achieve this is the Bermuda Health Plan.
The public consultation is asking two questions:
- What should be included in Bermuda’s core health insurance plan? And
- How should we transition to a more efficient system?
So, why are we doing this?
Because the structure of Bermuda’s health system is not capable of taking care of all of our people any more.
To be clear, we do have some exemplary strengths, but we also have some major challenges.
- We are the 3rd most expensive health system but rank 13th in life expectancy.
- Health costs consume nearly 12 percent of GDP
- 3 in 4 adults are overweight or obese and more than half of adults have one to two chronic disease risk factors
- More than 1 in 10 adults have diabetes; and
- Of every dollar we spend each year, 10 cents are spent on just 2 preventable conditions – chronic kidney disease and diabetes
To get a different result, we have to do things differently.
So what are we doing about it?
The Bermuda Health Plan wants to make sure the core health insurance plan includes benefits to keep you healthy and gives people the protection they really need.
We have heard the concerns of persons within our community who find it difficult to pay for their necessary medications.
Or persons who are unable to see their doctors as they are unable to afford the co-pay.
We are trying to add benefits like prescriptions and more office visits. This would make everyone’s core coverage better without taking anything away.
For example, FutureCare would still cover $2,000 for prescriptions and could even go up to $2,400. HIP could get some prescription benefits, and better office visits coverage.
In short, we are trying to add benefits to the core plan, which currently mainly covers hospitalization. Supplemental benefits in HIP and FutureCare will actually be improved. And so should the benefits in private plans.
What is clear, is that the Bermuda Health Plan will not take any benefits away.
The Bermuda Health Plan reforms also aim to ensure everyone is able to buy core coverage at an affordable price. To do this, the Government decided, after lengthy consultation, to use a single insurer to sell the core plan.
Why?
Because if the administration of the core benefits comes under one insurer, it will make business costs and overheads less expensive. With those savings in our total healthcare spend, more monies can be applied towards important services like chronic disease management, more prevention, regulation of prescription drug prices and dispensing fees.
The core plan will be cheaper in one large pool than split among thousands of pools as it is now. It’s the law of big numbers.
I was quoted in the daily yesterday as being ‘grateful’ for the public feedback. In fact, I am truly grateful for the public feedback. If I didn’t want to hear it, I would not have undertaken a four month period of dialogue and discussion.
We as a Government are actively engaged and consulting.
We have had over 50 consultation meetings with more than 600 participants.
It is a true and genuine act of listening. And we are hearing excellent feedback.
We have heard that $400 for prescriptions in the “mock plan” is too little. That allied health services like physiotherapy and occupational therapy need to be included.
We have heard that people want better coverage for primary care, but we have a long way to go before we reach agreement with physicians on how to achieve this.
And we have heard votes of thanks for proposing to extend the Personal Home Care benefit to all eligible residents – not just for HIP and FutureCare members as it is now.
We have also heard doctor’s and dentists’ mobilization of the community to oppose the reforms. Specifically, to oppose the institution of a single payer system.
We understand people’s concerns. No one wants to see healthcare quality diminish, or monstrous monopolies that no one can control.
But neither of these need to happen. Healthcare, as a public good, needs proper regulation to ensure everyone can access it. And adding benefits to the core plan will improve access.
We have years of experience with the standard health benefit coverage and no one has argued the quality is poor. We are certain that adding more community services to the standard health benefit will only improve quality and access.
The four month public consultation phase is nearly over – it ends on 8th December. After this, Working Groups will be set up to consider the feedback from the public and they will make recommendations on how we should proceed.
Nothing will be rushed. And decisions will be made in consultation with the stakeholders affected.
The first step in the fall of 2020 may be something as simple as adding prescription drugs to the standard health benefit. There will not be a sweeping overhaul of our healthcare in one fell swoop. We will make changes gradually, intentionally and together – for the benefit of all Bermuda.
With this said, I will take my seat and look forward to this evening’s discussion.
Thank you."